Active Voice: Can Creatine Supplementation Improve Properties of Muscle and Bone Mass in Older Adults?
By Darren G. Candow, Ph.D., and Philip D. Chilibeck, Ph.D.

After the fourth decade of life, muscle and bone mass decrease by ~ 1%-2% per year. This age-related reduction in muscle and bone (including muscle density and bone geometry, as indicators of muscle and bone quality) increases the risk of falls and fractures. Approximately one-in-three older adults experience a fall each year, with many experiencing multiple falls. Falls may lead to physical inactivity and premature morbidity. Therefore, lifestyle interventions that improve properties of muscle and bone may potentially reduce the risk of falls and fractures in older adults.

It is well established that resistance training has favorable effects on properties of muscle and bone in older adults. Accumulating research over the past two decades indicates that the combination of creatine supplementation and resistance training has the potential to lead to greater muscle and bone benefits. However, the effects of creatine supplementation and resistance exercise on decreasing the risk of falls and fractures in older adults is unknown. Creatine is synthesized in the human body (about 2-3 grams/day) from reactions involving the amino acids arginine, glycine and methionine in the kidneys and liver. The vast majority of creatine (95%) is stored in skeletal muscle, with smaller amounts stored and metabolized by bone. As a byproduct of creatine metabolism, about 2-3 grams/day is excreted from the body as creatinine. Creatine can also be consumed from the diet (typically about 2-3 grams/day) from food products such as red meat and seafood. However, depending on habitual dietary intake or preference (i.e., low meat intake, vegetarianism), it may be difficult to consume adequate amounts of creatine for effective changes in muscle or bone (i.e., > 3 grams/day). Therefore, many individuals supplement their diet with commercially available dietary supplements containing creatine (i.e., creatine supplementation).

In our study, reported in the November issue of Medicine & Science in Sports & Exercise®, we examined the effects of creatine supplementation (0.1 grams per kg body weight per day or about ~ 8 grams/day) and supervised, whole-body resistance training (3 sets of 10 repetitions for 14 exercises; 3 days per week for 1 year) in 53 healthy older adults (= 50 years of age). Results of our study indicated that older adults who supplemented with creatine experienced significant increases in lower-leg muscle density and bone area (i.e., tibia) compared to those on placebo, as measured using peripheral quantitative computed tomography (pQCT). These preliminary results are important because increasing muscle density and bone area (i.e., size) in the legs reduces the risk of suffering a fall or fracture in older adults. From a practical perspective, the combination of creatine supplementation and whole-body resistance training (for at least one year) may be a viable lifestyle intervention for older adults to improve some measures of muscle and bone.

This study was supported by the Canada Foundation for Innovation and Saskatchewan Health Research Foundation.

About the authors:
Darren G. Candow, Ph.D., currently serves as professor and supervisor of the Aging Muscle and Bone Health Laboratory in the faculty of Kinesiology and Health Studies at the University of Regina in Saskatchewan, Canada. His research focuses on nutritional interventions, primarily creatine supplementation, and resistance training on properties of muscle and bone. During the past 10 years, Dr. Candow has published 40 peer-reviewed articles involving creatine supplementation. Dr. Candow earned his Ph.D. from the University of Saskatchewan under the mentorship of Dr. Philip D. Chilibeck.

Philip D. Chilibeck, Ph.D., is a professor in Kinesiology at the University of Saskatchewan. His research involves exercise and nutritional interventions for improving health in a variety of clinical populations and performance of athletes.

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